PUBLISHED UNITED STATES COURT OF APPEALS FOR THE FOURTH CIRCUIT No. 19-1910 JOHN DOE 4, by and through his next friend, NELSON LOPEZ, on behalf of himself and all persons similarly situated, Plaintiff – Appellant, v. SHENANDOAH VALLEY JUVENILE CENTER COMMISSION, Defendant – Appellee. ____________________________ CURRENT AND FORMER STATE ATTORNEYS GENERAL; ELECTED PROSECUTORS; CORRECTIONS LEADERS, CRIMINAL JUSTICE LEADERS; DISABILITY RIGHTS LEADERS, Amici Supporting Appellant. Appeal from the United States District Court for the Western District of Virginia, at Harrisonburg. Elizabeth Kay Dillon, District Judge. (5:17-cv-00097-EKD-JCH) Argued: October 28, 2020 Decided: January 12, 2020 Before GREGORY, Chief Judge, WILKINSON, and KEENAN, Circuit Judges. Reversed and remanded by published opinion. Chief Judge Gregory wrote the opinion, in which Judge Keenan joined. Judge Wilkinson wrote a dissenting opinion. ARGUED: Theodore A. Howard, WILEY REIN, LLP, Washington, D.C., for Appellant. Jason A. Botkins, LITTEN & SIPE, LLP, Harrisonburg, Virginia, for Appellee. ON BRIEF: Hannah E.M. Lieberman, Mirela Missova, WASHINGTON LAWYERS’ COMMITTEE FOR CIVIL RIGHTS AND URBAN AFFAIRS, Washington, D.C., for Appellant. Joshua S. Everard, LITTEN & SIPE, LLP, Harrisonburg, Virginia; Harold E. Johnson, Meredith M. Haynes, WILLIAMS MULLEN, Richmond, Virginia, for Appellee. Neil R. Ellis, Mark E. Herzog, David A. Miller, SIDLEY AUSTIN LLP, Washington, D.C., for Amici Current and Former State Attorneys General, Elected Prosecutors, Corrections Leaders, Criminal Justice Leaders, and Disability Rights Leaders. 2 GREGORY, Chief Judge: Appellants are a class of unaccompanied immigrant children detained at Shenandoah Valley Juvenile Center who challenge the adequacy of their medical care. After fleeing their native countries due to harrowing traumas, many of these children struggle with severe mental illnesses, resulting in frequent self-harm and attempted suicide. Appellants filed a class action suit alleging, among other things, that the Shenandoah Valley Juvenile Center Commission fails to provide a constitutionally adequate level of mental health care due to its punitive practices and failure to implement trauma-informed care. The district court granted summary judgment to the Commission after finding that it provides adequate care by offering access to counseling and medication. But the district court incorrectly applied a standard of deliberate indifference when it should have determined whether the Commission substantially departed from accepted standards of professional judgment. Accordingly, we reverse and remand for further proceedings so that the court may apply the appropriate standard and consider all evidence relevant to it. I. Appellants are immigrant children who fled their native countries—mainly Honduras, Guatemala, Mexico, and El Salvador—after experiencing appalling horrors. Some have been brutally assaulted, including by their own families. J.A. 1116–17, 1128, 1246–49. Others have seen their friends and families murdered before their eyes. Id. All faced circumstances so dire, they were forced to flee hundreds of miles for safety. 3 Under federal law, Appellants are unaccompanied alien children (“UACs”): children under the age of 18 who have no lawful immigration status 1 and no parent or legal guardian in the United States available to care for them. 6 U.S.C. § 279(g)(2). Upon arrival in the United States, they fall under the custody of the ...
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